Facts Not Fear: COVID Data Demands Vigilance

Posted on June 10, 2020 by Jonathan Lips

Events of the past week illustrate the power of data to shape the public’s understanding of COVID-19 and how the virus impacts aging services providers and the people you serve.  Unfortunately, these examples are a powerful reminder that inaccurate data or inaccurate reporting can distort that understanding.  

What Happened

Two sets of data on positive cases and deaths in specific settings became available for public review and study became available on June 4 and June 5.

• Federal: CMS publicly released data that nursing homes have reported to the CDC National Healthcare Safety Network (NHSN) for the weeks ending May 24 and 31, including total cases and deaths among residents and staff, access to supplies and testing, and the other required data elements.  As CMS itself explains, this is preliminary data and will be subject to fluctuations as facilities are given the opportunity to submit and correct their data on the NHSN website. CMS cautions that data reported over the first few weeks should not be used to perform trend analysis, but we believe it will provide a useful foundation for national benchmarking once the data stabilizes.
• State: In response to a formal request from Senator Karin Housley, the Minnesota Department of Health (MDH) provided a variety of information on the status of COVID-19 in nursing homes and assisted living, including a list of cases and deaths in settings with more than 10 residents.

Media outlets moved quickly to publish stories based on this data, which we fully support. The steps MDH has taken toward transparency during the COVID crisis are important, and we will continue to support CMS and MDH efforts to gather and share public health data in ways that better inform surveillance, prevention and treatment. Unfortunately, however, inaccuracies have us working overtime to correct the facts and public perception.

Relying on a flawed understanding of the CMS data, the Star Tribune printed an article (Saturday, June 6) entitled “Feds Outline Care Crisis” that featured inaccurate information about COVID-19 cases in Minnesota nursing homes. The Star Tribune grossly exaggerated the number of deaths in 10 nursing homes and even spotlighted a nursing home for having 33 COVID-related deaths when actually no one has died from the virus there.

Meanwhile, following MDH’s release of data to Sen. Housley, MINNPOST reported a summary of the information and posted a link to the data within its story. The problem here was not with the reporting but with the accuracy of the MDH data. Shortly after the data was posted, LeadingAge Minnesota members began finding errors - including sites listed with confirmed positive resident cases where in fact there are none.

We also identified another problem: The cases and deaths in long-term care settings as published by MDH is generally accurate in aggregate. However, detailed review shows that the agency is displaying data for campuses as a single line item – listing them as either skilled nursing or assisted living and not tracking the setting types separately if a campus has both. This treatment of campuses means the breakdown-by-setting of confirmed resident cases and deaths is inaccurate and may cause other problems (i.e., determining qualification for higher EW rates).

Our Response

On the State front, we notified MDH of our concerns about the list and will continue to push the agency to correct and refine the data so it portrays an accurate picture.  In this work, your efforts will be critical. We urge all members to review the list of confirmed resident cases and deaths and determine if there are any errors in what you see.  If yes, please notify Jeff Bostic on our team, and we will relay those to MDH.

Please know that we stepped into immediate action to correct the inaccuracies and misrepresentations caused by the Star Tribune’s egregious reporting on the CMS data.

We immediately contacted the Star Tribune to seek a correction on this story when we saw it posted online. While the story was revised in its online version, it was too late to correct the error for the print edition. The Star Tribune noted the error in a brief correction in the Sunday, June 7 newspaper. While the corrections were needed, the damage was already done. LeadingAge Minnesota and Care Providers of Minnesota also requested a meeting with representatives from the Star Tribune’s editorial team to discuss this error and also the serious double-standard in the newspaper’s coverage of the health care sector’s response to COVID-19 and the consistent misrepresentation of the voice of senior care providers as well as the quality of services provided. The Star Tribune has agreed to meet.

In addition, the Long-Term Care Imperative distributed a letter to lawmakers to notify them of the inaccurate reporting in the Star Tribune in case they were alarmed by the story and provide them with context in case they heard from their constituents.

Two Steps Providers Should Take

If you have/had positive cases in your setting and/or experienced loss of life due to COVID-19, you should prepare to respond to questions or consider sharing this information more broadly before being asked – particularly if you have not previously informed residents and families of positive cases and deaths in your setting. We have prepared some key messages on how to respond to questions and concerns that you may get as well as provided links to three communication toolkits that can help you respond. Once we review the data in more detail, we will update these resources. Download the Messaging Resource.

We also recommend that you review and monitor public-facing data about your setting, including these:

• All care centers and housing/assisted living providers should check the list of confirmed cases MDH provided to Sen. Housley (see link above).
• All care centers and housing/assisted living providers should review the roster of Congregate Care Facilities with Exposures by County that MDH posts to its COVID-19 Situation Update webpage.  This list will grow over time, and it’s possible errors will occur.  As one example, the list should not contain settings with 10 or fewer residents (for data privacy reasons), but we are aware of at least one case where such a setting was identified.
• Care centers should monitor the CMS National Healthcare Safety Network data for accuracy, and remember that this data will be updated weekly.
• Care centers should also monitor the Nursing Home Compare site, and your facility’s individual profile to gain insight into the infection control focused survey data that CMS is spotlighting there (see our separate story in this week’s Advantage newsletter).

Best Practice: Transparency Builds Trust & Cooperation

The best way to counter inaccurate media stories and misperception is through transparency. Please see our COVID-19 Resource Round-up story this week for a best practice that will help you share information directly with residents and families -- and the -- public. 

Please do not hesitate to reach out to us on any of these issues. We are here for you. To support you, to counter false narratives, and to advocate for you and the people you serve.